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How to Talk About Trauma in Therapy

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Feb 13, 2023

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This piece was written by guest contributor Emily Win and clinically reviewed by fellow FOLX clinician Kaity Stewart, CNM PMHNP-BC. Illustrations were drawn by Ocean Mateus.


When it comes to managing mental health, we often hear about trauma therapy or trauma informed therapy. Particularly, COVID-19 has pushed the importance of discussing collective trauma into the mainstream.

Trauma therapy is an umbrella term for different kinds of therapies. While some therapists specialize in certain types of psychotherapy, others use a combination of techniques specific to the healing of the client. Additionally, it’s important to distinguish trauma from Post Traumatic Stress Disorder (PTSD); some people seek therapy to process traumatic events but don't necessarily have PTSD, so the treatment and approach can look different.

What makes a therapist trauma-informed involves the practice of creating a safe environment for a person to feel empowered to share their story, process trauma, and work towards healing. The goal of the therapist is to approach each person with the understanding they have their own individual traumatic experiences.

Many therapists can use a trauma-informed approach with certain techniques, but some modalities lend themselves more to the sensitivity of trauma survivors than others. There isn’t a specific modality for trauma therapy that works for everyone, so it often depends on what someone's goals are. For instance, if your therapeutic goal involves changing your thought and behavior patterns, you might consider trying out cognitive behavioral therapy (CBT).

However, talk therapy generally can be an excellent place to process traumatic experiences. This opportunity gives you the time and space to safely work through any emotions that may come up whether they’re directly or indirectly associated with specific types of trauma.

While someone doesn't necessarily need a trauma-focused therapist to talk about traumatic memories in therapy, it’s often a great keyword to use when looking for a therapist. Seeking out a trauma-informed therapist may be a good starting place to ensure you find someone safe and trained to work with.

One of the most important things psychological trauma survivors can do before disclosing their stories in a therapy session is to pay attention to what their body is telling them. If a certain sound or thought makes your heart beat faster and your vision blurry, for instance, you might want to pay attention to how your nervous system is reacting to that trigger. Common symptoms of trauma include: intrusive memories, avoidance, negative changes in thinking and mood, and changes in physical and emotional reactions, which includes behaviors like trouble sleeping, trouble concentrating, and irritability. Many therapists will suggest coping skills and coping strategies in a therapy session through psychoeducation, such as self-care strategies. This is often as simple as understanding how your brain reacts to certain stimuli or learning breathing techniques when you start to notice symptoms of an anxiety attack. Simply understanding the connection between your mind and body can be a great starting point to understanding your own coping mechanisms. Developing a resilient skillset can help reduce emotional distress related to trauma.

Know that your traumatic event or experience isn’t your fault. Even childhood trauma can affect adults through experiences, such as panic attacks, flashbacks or dissociation that can impact attachment styles and emotional regulation. Working through, or even naming past traumas, can bring about new memories, symptoms, or associations, but it’s important to remember that your experiences and posttraumatic symptoms are not reflections of you or any decision you made. Trauma can exist on an individual or global scale and we must be cognizant to the many layers that could be affecting our behaviors. For example, many people around us likely carry some sort of trauma from the COVID-10 pandemic. Many of us carry traumas in our everyday lives that often impact our minds and bodies more than we realize. 

When looking for a trauma-trained therapist, you might come across a few different healing techniques and treatment approaches: eye movement desensitization and reprocessing (EMDR) and Prolonged Exposure (PE) therapy. EMDR is described as "a structured therapy that encourages the patient to briefly focus on the trauma memory while simultaneously experiencing bilateral stimulation (typically eye movements),” according to the American Psychological Association. Through this process, the goal is to reduce "vividness and emotion associated with the trauma memories." Prolonged Exposure (PE), otherwise known as exposure therapy, involves being gradually exposed to trauma-related memories, feelings and situations by facing a fear we’ve been avoiding: "A person presumably learns that the trauma-related memories and cues are not dangerous and do not need to be avoided." Both of these evidence-based treatments have helped many people work with their Post-Traumatic Stress Disorder (PTSD) and generalized trauma.

Another avenue to consider is somatic experiencing (SE). SE utilizes your nervous systems' natural reactions such as dizziness, hot/cold sensation, or numbness to track how your body is responding to the memories of the trauma. A therapist will then guide you through different release techniques called pendulation. It's important to note that SE doesn't have the research and evidence behind it as the other trauma-related treatments. 

While many therapists claim that they work with trauma-survivors, it's crucial to know that a "real trauma therapist is a licensed mental health professional who has had explicit training, supervision, and clinical experience working directly, and perhaps almost exclusively, with trauma." Things to look out for include a clinical focus on trauma, specific training in trauma, and specializations in evidence-based treatment practices. Recognizing your own traumas and finding help can be a scary journey, but know that there are many resources available to you, to bring you towards an improved mental well-being.

FOLX HEALTH's new behavioral health program is coming in early 2023. Be the first to give us your feedback here and be part of building this special offering with us.

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